Acute kidney injury in children – not just for the nephrologist

Abstract

Acute kidney injury (AKI) is a condition that is characterised by an abrupt reduction in kidney function, and is not limited to acute renal failure. However, it is potentially treatable. Failure to do so may result in death or  progression to chronic kidney disease (CKD). AKI requires urgent management in order to ensure a better clinical outcome. Traditionally, AKI is classified according to aetiology, i.e. pre-renal, intrinsic renal and post-renal AKI. Clinical features depend on the age of the patient, the cause and related complications. Symptoms and signs may be non-specific, e.g. poor feeding and vomiting, or more specific, e.g. oedema, macroscopic haematuria and oliguria. The staging of AKI is based on the estimated glomerular filtration rate and urine output. AKI from any cause increases the risk of CKD developing, and vice versa. There are absolute indications for renal  replacement therapy, e.g. anuria, whereas other patients can be managed successfully conservatively.

Keywords: acute kidney injury, AKI, children, fluid management, pRIFLE, renal replacement therapy